Evaluation of Depression Screening Implementation in the Adult Inpatient Heart Failure Population: A Process Outcomes Evaluation

BACKGROUND: Extensive study has found depression in heart failure (HF) patients to be a significant risk factor which has been associated with poor outcomes and increased medical cost for this population. It is highly recommended to screen HF patients for depression to identify this important risk factor. The PHQ-9 depression screening instrument (sensitivity 70% specificity 92%) has been identified as a valid measure to detect depression in the HF population. Implementing a depression screening protocol in an inpatient environment requires education of providers to establish awareness of best practice and foster confidence in their application of the screening instrument. OBJECTIVE: To determine if a correlation exists between provider knowledge of depression screening in the HF population, and adherence to a depression screening protocol. METHODS: A literature review was conducted to determine appropriate depression screening instruments for use in the HF population. Results were utilized to develop an education plan with pre-posttest, and depression screening protocol for implementation. A pilot study was conducted in the critical care unit of Norton Brownsboro Hospital (NBH) from September 27, 2017 through October 30, 2017. RESULTS: Adherence to the screening protocol was 40.6 percent. Pre-post assessment of provider knowledge following provider education was correct and unchanged for three out of four knowledge items. Significant (P \u3c .05) increase of knowledge (P= .002) for the remaining item. Perceptions of the burden of untreated/undetected depression in the HF population increased significantly (P= .001, P= .04, P= .09). CONCLUSIONS: No association between knowledge and adherence to a depression screening protocol was found. Provider knowledge showed significant increase after an education intervention. These results indicate that more is required beyond effective education of providers to achieve the goal of depression screening in the inpatient HF population